Inflammatory Bowel Disease: Ulcerative Colitis

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  • 0:39 What Is Ulcerative Colitis?
  • 1:13 What Occurs in…
  • 3:20 Ulcerative Colitis Vs.…
  • 5:03 Clinical Signs,…
  • 5:46 Treatment of…
  • 6:05 Lesson Summary
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Lesson Transcript
Instructor: Artem Cheprasov
This lesson will discuss an inflammatory bowel disease known as ulcerative colitis. We will review the reasons for its occurrence and most importantly how it differs from another IBD known as Crohn's disease.

Differences Between Similar Things

You say 'pota-toh,' and I say 'puhtato.' You say 'tomay-to,' and I say 'to-mah-to.' That may or may not mean we're referring to the same thing. There are different shapes, colors, and varieties of tomatoes and potatoes, but that doesn't mean they're all exactly the same.

This brings me to the fact that even though inflammatory bowel diseases, which cause your bowels to become as inflamed and red as most tomatoes, have a lot of overlap, they're not necessarily the same. That's what this lesson will help to distinguish when it comes time to differentiating Crohn's disease and ulcerative colitis, two types of inflammatory bowel disease.

What Is Ulcerative Colitis?

Another lesson went into the details of Crohn's disease, but here we'll first focus in on ulcerative colitis, a type of chronic inflammatory bowel disease.

This disease is most likely to affect people of European ancestry and those under the age of 30.

The use of medications such as NSAIDs, smoking, milk consumption, and genetic mutations have all been linked to this problem.

The real problem is that we don't actually know how many of these things cause and how many of them just exacerbate ulcerative colitis, or both. It's a true Sherlock Holmes-type mystery.

What Occurs in Ulcerative Colitis?

In people with ulcerative colitis, it has been noted that a subset of white blood cells, called T-cells, accumulate in the mucosa of the colon. The mucosa is the layer of intestines that comes into contact with anything located inside the hollow space inside the intestines, called the intestinal lumen. An increase in IgE antibodies produced by plasma cells has been noted as well. These plasma cells, a specialized type of white blood cell called a B-cell, are called antibody-producing factories.

Actually, I like to think of them more of as a queen ant. You know that queen ants lay millions of eggs that give rise to identically looking ants. Well, plasma cells give birth to identical antibodies. These antibodies are like worker ants: they go into circulation and begin attaching to anything they perceive as a threat, just like ants would latch onto an invader. Those antibodies then recruit other inflammatory cells to the area, which begin secreting all sorts of digestive enzymes, like ants would, to destroy the surrounding tissue. Problem is, these inflammatory molecules, cells, and proteins begin destroying your own colon, leading to inflammation and ulceration of the colon.

This is what gives ulcerative colitis its name. 'Colitis' refers to the inflammation of the colon, and 'ulcerative' means that this inflammation gives rise to ulcers, a deep defect in the intestinal tissue that leads to bleeding. This increased bleeding can, over time, lead to anemia and can result in lethargy and weakness. If you don't have enough red blood cells, it's kind of hard to be active since the red blood cells deliver oxygen necessary to drive energetic processes.

Just imagine if there was a leak in the gas tank of a car as a result of hole being punched into the tank itself. That hole is like an ulcer. Over time, enough gas would leak out to the point that the car wouldn't be able to run very well since the car would have no energy to drive anymore.

Ulcerative Colitis vs. Crohn's Disease

Okay, I'm getting ahead of myself now. I want you to please watch the video on Crohn's disease if you have not done so already. It will be important for this next section since we didn't have time for it during that lesson. Ulcerative colitis and Crohn's disease overlap in many ways but also must be distinguished since they're not exactly the same, just like a tomato and tomahto may be a bit different.

There are exceptions to some of the things I'm about to tell you, but don't worry about it for now. You'll have plenty of time for that when you immerse yourself further in this topic in medical school.

Crohn's disease can occur anywhere in the GI tract, from the mouth all the way down to the anus. Ulcerative colitis is located from the rectum up through the colon only. The damage caused by Crohn's disease is found in patches here and there, dispersed throughout the GI tract, called skip lesions, whereas ulcerative colitis causes a continuous inflammation of the colon.

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